Conflict of interest: Nothing to report.
Comparison of real-time microvascular abnormalities in pediatric and adult sickle cell anemia patients†
Article first published online: 24 SEP 2010
Copyright © 2010 Wiley-Liss, Inc.
American Journal of Hematology
Volume 85, Issue 11, pages 899–901, November 2010
How to Cite
Cheung, A. T.W., Miller, J. W., Craig, S. M., To, P. L., Lin, X., Samarron, S. L., Chen, P. C.Y., Zwerdling, T., Wun, T., Li, C.-S. and Green, R. (2010), Comparison of real-time microvascular abnormalities in pediatric and adult sickle cell anemia patients. Am. J. Hematol., 85: 899–901. doi: 10.1002/ajh.21853
- Issue published online: 25 OCT 2010
- Article first published online: 24 SEP 2010
- Accepted manuscript online: 18 AUG 2010 12:00AM EST
- Manuscript Accepted: 30 JUL 2010
- Manuscript Revised: 28 JUL 2010
- Manuscript Received: 18 MAY 2010
- National Institutes of Health. Grant Number: R01 HL83276
- National Center for Research Support. Grant Number: UL1-RR024146
The conjunctival microcirculation in 14 pediatric and eight adult sickle cell anemia (SCA) patients was studied using computer-assisted intravital microscopy. The bulbar conjunctiva in SCA patients in both age groups exhibited a blanched/avascular appearance characterized by decreased vascularity. SCA patients from both age groups had many of the same abnormal morphometric [vessel diameter, vessel distribution, morphometry (shape), tortuosity, arteriole:venule (A:V) ratio, and hemosiderin deposits] and dynamic [vessel sludging/sludged flow, boxcar blood (trickled) flow, and abnormal flow velocity] abnormalities. A severity index (SI) was computed to quantify the degree of vasculopathy for comparison between groups. The severity of vasculopathy differed significantly between the pediatric and adult patients (SI: 4.2 ± 1.8 vs. 6.6 ± 2.4; P = 0.028), indicative of a lesser degree of overall severity in the pediatric patients. Specific abnormalities that were less prominent in the pediatric patients included abnormal vessel morphometry and tortuosity. Sludged flow, abnormal vessel distribution, abnormal A:V ratio, and boxcar flow appeared in high prevalence in both age groups. The results indicate that SCA microvascular abnormalities develop in childhood and the severity of vasculopathy likely progresses with age. Intervention and effective treatment/management modalities should target pediatric patients to ameliorate, slow down, or prevent progressive microvascular deterioration. Am. J. Hematol., 2010. © 2010 Wiley-Liss, Inc.